Ayşe Nur Keleş

Can aquaporins be used as diagnostic and prognostic markers for uterine smooth muscle tumours

ABSTRACT Generally, uterine leiomyosarcoma is easily diagnosed. However, uterine smooth muscle tumours which show atypical histological features and unusual growth patterns may mimic malignancy and may not be easily diagnosed. In this study, our aim is to show the expressions of Aquaporin3, Aquaporin7 and Aquaporin9 in uterine smooth muscle tumours, and to investigate if aquaglyceroporins can be used as diagnostic and prognostic markers to start rapidly an appropriate treatment for patients with these tumours in order to extend the survival time. We determined that there had been 74 patients diagnosed with uterine smooth muscle tumours. We divided patients into four groups based on the diagnosis: bizarre leiomyoma, smooth muscle tumour of uncertain malignant potential, leiomyosarcoma and leiomyoma. Aquaporin3, Aquaporin7 and Aquaporin9 were detected by using monoclonal anti-Aquaporin3, anti-Aquaporin7 and anti-Aquaporin9 antibodies, respectively. In leiomyosarcoma group, we observed a statistically significant relation of Aquaporin3 expression with survival time, grade, stage, mitotic index and Ki-67 score. A significant relation of both Aquaporin7 and Aquaporin9 expressions with survival time, grade, stage was not statistically detected in leiomyosarcoma group. The decrease of Aquaporin3 expression can be used as important diagnostic and prognostic marker. Aquaporin7 and Aquaporin9 expressions cannot be used as diagnostic and prognostic markers.

Primary thyroid lymphoma: mucosa associated lymphoid tissue lymphoma case

Primary thyroid lymphomas are lymphomas which are localized only to thyroid gland or thyroid gland and surrounding lymph nodes. Frequently these are mucosa associated lymphoid tissue (MALT) lymphomas with B cell origin. Our case is a 78-year-old female patient who admitted with a neck mass and had been operated with the suspicion of malignancy. Histopathological examination revealed diffuse proliferation of atypical lymphoid cells that consists of small to medium sized cells, with irregular nuclear contours, some of which resemble centrocytes. Immunohistochemical staining was positive for CD20, CD79alpha, CD43, and lambda while negative for CD3, CD30, CD15, bcl-2, bcl-6, CD68, CD138, CD5, and CD10. With these finding, the case was considered as “primary thyroid MALT lymphoma”. Thyroid MALT lymphomas are characterized with the presence of atypical lymphocytes that originate from the marginal zones of lymhoid follicles. Immunohistochemically, while these lymphomas express the B cell associated antibodies (CD20, CD22, CD79a), conversely CD5, CD10, and CD3 expressions are not seen.

Aquaporin 1, Aquaporin 3 and Aquaporin 5 expression and EGFR mutation in malignant pleural mesotheliomas: an imunohistochemical and molecular study

ABSTRACT Malignant pleural mesothelioma is a rare and fatal malignancy. This disease is, unfortunately, at its advanced stage when it is diagnosed. Survival time is usually not more than a few months. The aim of this study was to analyse the expression of Aquaporin 1, Aquaporin 3 and Aquaporin 5 in malignant pleural mesotheliomas and to explore the relationship of these levels of expression with epidermal growth factor receptor (EGFR) gene mutation and prognostic parameters. In this study, 60 cases diagnosed as malignant pleural mesothelioma among the pleural biopsy materials in the archives of the Pathology Department of Medical Faculty of Dicle University in 2003–2013 were evaluated. The tissues were stained immunohistochemically with antibodies against Aquaporin 1, Aquaporin 3 and Aquaporin 5, and the existence of EGFR mutation was investigated in the tissues by real-time polymerase chain reaction (PCR). The obtained results showed expression of Aquaporin 1, Aquaporin 3 and Aquaporin 5 in varied amounts in malignant pleural mesotheliomas. However, no significant relation was obtained thus far between the expression levels of these aquaporins and the prognostic parameters. No mutations were detected in the EGFR gene exons 18–21 by using real-time PCR. It could be suggested that although Aquaporin 1, Aquaporin 3 and Aquaporin 5 are expressed in malignant pleural mesothelioma, they do not have any effect on the prognostic parameters. Mutations in different domains of EGFR gene, other than exons 18–21, should be sought to develop new targeted treatments.

Servikal adenoid bazal karsinom: Olgu sunumu

Adenoid basal carcinomas are rare tumors that accounts for less than 1% of all cervical cancers. Generally they are seen in postmenopausal women. Macroscopically these tumors do not reach large sizes. Microscopically adenoid basal carcinomas are composed of uniform, round, basaloid cells that form nests surrounded by palisade formations. These tumors express CAM 5.2, CK7, EMA, and CEA immunohistochemically. In evaluation of the material referred to our unit, an ulcerated mass lesion that is located on uterine posterior wall is determined. On microscopic examination of sections prepared from the mass, under the surface epithelium accompanied by severe dysplasia, a tumoral formation composed of basaloid cells is observed. It is seen that the tumor demonstrate configurations of nests and islets which comprise generally peripheral palisading. When the tumoral cells are characterized by mild to moderate pleomorphism and atypia, the mitotic index is detected low. In immunohistochemical studies, the tumoral cells are positively stained with CEA and CK7, and negatively stained with HMWCK, vimentin, CD34, and HPV18. Adenoid basal carcinoma cases typically do not manifest with local recurrence or metastasis and have very good prognosis. Our case has filled 48 months after the diagnosis and any local recurrence or metastasis has not been observed. J Clin Exp Invest 2014; 5 (4): 614-616

Goblet hücreli karsinoid: Olgu sunumu

The mixt endocrine-exocrine carcinoma of the appendix, being a rare tumor, makes up a very little part of all gasstrointestinal system tumors. These tumors are thought to be the intermediary tumors taking place between adenoscarcinomas and endocrine tumors. Generally they are seen in the 5th -6th decades equally in males and females. Being very characteristic, the histomorphological picture of goblet cell carcinoid consists of atypical epithelial cells with conspicuous nucleoli that make small abortive glands demonstrating scattered nests under surface epithelium and containing Goblet cells. The tumor exhibits transsmural spread producing mucin pools designating posistive immunoreaction histochemically with musicarmen stain. In addition to CEA and keratin expressions, there is neuroendocrine differentiation that may be illustrated both immunohistochemically and ultrastructurally. In our case, under the appendix epithelium we determined a tumor that was formed by gland structures lined by muscinous epithelial cells with conspicuous nucleoli, growing forward to the muscle layer and seeming invasive. We established that the tumor expressed PanCK, synaptosphysin, chromogranin and CEA in immunohistochemiscal study and stained positively with PAS, PAS-AB and musicarmen in histochemical study. We considered the case as goblet cell carcinoid when clinical, histopathologiscal, histochemical and immunohistochemical data were assessed together. In the time interval 2 years after the operation, any recurrence and/or metastase was not destermined.